Wuhan Central Hospital Research Articles

Relationship Between Farnesoid X Receptor and Macrophage Polarization Status in Colorectal Cancer

Objective: Most colorectal cancer patients are insensitive to immunotherapy, which is associated with the polarization state of macrophages in the immune microenvironment. Research indicates that the farnesoid X receptor can modulate the immune microenvironment of colorectal cancer, but its relationship with the polarization status of macrophages requires further investigation. This study aims to investigate the expression of farnesoid X receptor in colorectal cancer, and analyze its correlation with the clinical pathological features of colorectal cancer and the polarization status of macrophages. Methods: Pathological specimens from 31 cases diagnosed with colorectal adenocarcinoma and undergoing surgery at Wuhan Central Hospital between January 2022 and December 2022 were collected. Immunohistochemistry was employed to assess the expression of farnesoid X receptor in tumor cells and tumor stroma. The quantity of CD86-positive and CD206-positive cells in the samples was also measured to reflect the infiltration of M1 and M2 macrophages in the tumor immune microenvironment. Describe the expression of farnesoid X receptor in colorectal cancer tumor cells and tumor stroma, and analyze the relationship between farnesoid X receptor expression and clinical pathological features and macrophage polarization status. Results: The positive rates of farnesoid X receptor expression in tumor cells and tumor stroma were 29.03% and 45.16%, respectively. The expression of farnesoid X receptor in tumor cells was associated with tumor location (P=0.015), with a higher incidence of farnesoid X receptor expression loss in left-sided colon cancer compared to right-sided colon cancer. The expression of farnesoid X receptor in tumor stroma was correlated with macrophage polarization status. The positive expression of farnesoid X receptor in stroma was associated with a higher infiltration of M1-type macrophages (P=0.008) and a higher M1/M2 ratio compared to the farnesoid X receptor expression loss group (P=0.003), suggesting a better response to immunotherapy and a favorable prognosis. Conclusion: Farnesoid X receptor is expressed in both colorectal cancer tumor cells and tumor stroma, showing a close association with the primary site of colorectal cancer and the polarization status of macrophages. The positive expression of farnesoid X receptor in tumor cells is predominantly observed in right-sided colorectal cancer, while the positive expression of farnesoid X receptor in tumor stroma is associated with macrophage polarization towards the M1 phenotype.

Association between metformin treatment and coronary artery inflammation based on pericoronary adipose tissue attenuation in type 2 diabetes mellitus patients.

Cardiovascular disease (CVD) is the leading cause of mortality in type 2 diabetes mellitus (T2DM) patients. The role of metformin in reducing cardiovascular events is well-established, but its effect on coronary artery inflammation in T2DM patients is still unclear. In this study, we evaluated 547 T2DM patients who underwent coronary computed tomography angiography (CCTA) at Wuhan Central Hospital. Using propensity score matching, we compared the attenuation of pericoronary adipose tissue (PCAT), an imaging marker of coronary artery inflammation, between patients treated with and without metformin. Multiple linear regression models were used to analyze the influence of metformin on PCAT attenuation. The results of the propensity-matched analysis showed that patients on metformin therapy had significantly lower PCAT attenuation, indicating reduced coronary inflammation. Specifically, the PCAT attenuation in the left anterior descending artery (LAD) and right coronary artery (RCA) was lower in the metformin group compared to the non-metformin group. Metformin use was independently associated with decreased LAD-PCAT attenuation in the multivariate regression analysis. The association of metformin with PCAT attenuation differed significantly in populations analyzed in subgroups of patients with obesity and chronic kidney disease. In conclusion, our study shows a preliminary signal that metformin therapy may be associated with decreased coronary artery inflammation in T2DM patients, as indicated by PCAT attenuation on CCTA. And this correlation may vary depending on the patient population. This initial finding suggests that PCAT attenuation could be potentially used as an imaging biomarker to monitor the anti-inflammatory effects of medication.

COMMEMORATING AS CRITICIZING: HOW LI WENLIANG’S WEIBO HOMEPAGE BECOMES A PLACE FOR QUESTIONING CHINA’S COVID-19 POLICIES AND A “WAILING WALL”

Li Wenliang, an eye doctor at Wuhan Central hospital and one of the first to raise alarm about the outbreak of COVID-19, was summoned by the local police and forced to sign a statement reprimanding his message as a groundless rumor as well as a disturbance to the public order in late December 2019. Two months later, Li died after contracting COVID-19 at his workplace, aged 33 years. This caused shock and outrage across China and Li’s Weibo (China’s equivalent of Twitter) homepage soon became an online “wailing wall,” where people mourned, condoled, and commemorated the whistleblower and complained, questioned, and protested the overstrict government policies relevant to COVID-19 pandemic. This study shows that Weibo offers a place for users to see the mundane life of Li Wenliang, express grief and frustration, and interact with each other to remember Li, whereas another super-powerful Chinese social media, WeChat, allows users to synthesize information about Li, provide analysis and criticism, and circulate the memory of Li through their social networks. Together, these two platforms helped stabilize Chinese internet users’ memory of Li as a whistleblower, a civilian hero, a martyr, and a supporter of free speech and diverse voices, distinguished from the official version. This study contributes to recent scholarly interest in understanding how the technological affordances of social media shape memory work. It also shows that even in a politically constrictive environment, such as China’s media ecology, the space for questioning and protesting still exists, though more nuanced and precarious.

Artificial intelligence-enabled 8-lead ECG detection of atrial septal defect among adults: a novel diagnostic tool.

Patients with atrial septal defect (ASD) exhibit distinctive electrocardiogram (ECG) patterns. However, ASD cannot be diagnosed solely based on these differences. Artificial intelligence (AI) has been widely used for specifically diagnosing cardiovascular diseases other than arrhythmia. Our study aimed to develop an artificial intelligence-enabled 8-lead ECG to detect ASD among adults. In this study, our AI model was trained and validated using 526 ECGs from patients with ASD and 2,124 ECGs from a control group with a normal cardiac structure in our hospital. External testing was conducted at Wuhan Central Hospital, involving 50 ECGs from the ASD group and 46 ECGs from the normal group. The model was based on a convolutional neural network (CNN) with a residual network to classify 8-lead ECG data into either the ASD or normal group. We employed a 10-fold cross-validation approach. Statistically significant differences (p < 0.05) were observed in the cited ECG features between the ASD and normal groups. Our AI model performed well in identifying ECGs in both the ASD group [accuracy of 0.97, precision of 0.90, recall of 0.97, specificity of 0.97, F1 score of 0.93, and area under the curve (AUC) of 0.99] and the normal group within the training and validation datasets from our hospital. Furthermore, these corresponding indices performed impressively in the external test data set with the accuracy of 0.82, precision of 0.90, recall of 0.74, specificity of 0.91, F1 score of 0.81 and the AUC of 0.87. And the series of experiments of subgroups to discuss specific clinic situations associated to this issue was remarkable as well. An ECG-based detection of ASD using an artificial intelligence algorithm can be achieved with high diagnostic performance, and it shows great clinical promise. Our research on AI-enabled 8-lead ECG detection of ASD in adults is expected to provide robust references for early detection of ASD, healthy pregnancies, and related decision-making. A lower number of leads is also more favorable for the application of portable devices, which it is expected that this technology will bring significant economic and societal benefits.

Prognostic value of neutrophil-to-lymphocyte ratio on proteinuria remission in patients with idiopathic membranous nephropathy.

As a novel marker of inflammation, the neutrophil-to-lymphocyte ratio (NLR) has been studied in various diseases. However, NLR in idiopathic membranous nephropathy (IMN) has been rarely studied. We sought to assess the role of NLR in predicting proteinuria remission in IMN. This retrospective study involved 561 patients with IMN from January 2018 to December 2022 in Department of Nephrology of Wuhan Central Hospital. All baseline data were collected before the immunosuppressive regiment was administered. The Cox proportional hazards model and Kaplan-Meier curve were applied to assess the prognostic value of NLR for proteinuria remission. The area under the receiver operating characteristic curve revealed that the optimal cut-off NLR value for predicting proteinuria non-remission was 2.63, with a sensitivity and specificity of 58.2% and 72.7%, respectively. Kaplan-Meier curves showed a lower rate of proteinuria remission in patients with high NLR compared with low NLR (Log-rank = 5.04, p = 0.025). Multivariate Cox regression analysis showed that high NLR was an independent risk factor for proteinuria non-remission after adjustment (HR = 1.579, 95% CI 1.052-2.683, p = 0.023). Subgroup analysis indicated that high NLR was a risk factor for proteinuria non-remission especially in IMN patients with 24h proteinuria ≥ 1g (HR = 1.818, 95% CI 1.031-2.573, p = 0.012) and chronic kidney disease (CKD) stage 3-4 (HR = 1.935, 95% CI 1.084-2.495, p = 0.015). The current study shows that NLR is an independent risk factor for proteinuria non-remission in IMN. More attention should be paid to IMN patients with high NLR, especially for those patients with 24h proteinuria ≥ 1g and CKD stage 3-4.

The SARS-CoV-2 Pandemic: Confusion and Crisis at the Wuhan Central Hospital, China

The SARS-CoV-2 Pandemic: Confusion and Crisis at the Wuhan Central Hospital, China

“What's going on with my China?”: Political subjectivity, scalar inquiry, and the magical power of Li Wenliang

AbstractThis article examines how the death of Li Wenliang, in February 2020, served as an affordance for Chinese netizens to engage with their intimate sense of themselves as political subjects through the interrogative process of scalar inquiry. Li, an ophthalmologist at Wuhan Central Hospital who was sanctioned by Chinese authorities in 2019 for warning friends about the virus, was also an eminently normative and successful Han Chinese citizen who many saw as a reflection of themselves. His persecution, public humiliation, and death thus indexed the vulnerability of even the most compliant subjects and triggered an unprecedented public response that included both grief and outrage. Although largely censored within hours, this response continued to emerge throughout the year in a public mega‐thread on his Weibo “Wailing Wall.” This article draws on an alternative archive of censored messages on Li's Weibo page—usually described as an affective, apolitical space—to demonstrate how the Wailing Wall also becomes a unique sociomoral space in which people collaboratively reflect upon their sense of themselves as embodied subjects. Scalar inquiry, I suggest, thus emerges as a continual, collaborative, and simultaneously personal and political process of interrogating citizenship and nationhood vis‐à‐vis the remembered past, the experienced present, and the anticipated future.

“This is China’s Wailing Wall”

AbstractDr. Li Wenliang, an ophthalmologist at Wuhan Central Hospital, was accused of spreading rumors when he sent a WeChat message containing the diagnostic report of a suspicious pneumonia case to a group of friends. When he later died from COVID-19, his Weibo page quickly become known as “China’s Wailing Wall,” where hundreds of thousands of netizen shared replies to his final post in a mega-thread that continues into the present. Drawing upon a selection of posts from an archive of messages posted to Li’s Weibo in the year following his death, this article examines how participants used chronotopes (Bhaktin 1981) to situate Li vis-à-vis various culturally salient “figures of personhood” (Agha 2005;Park 2021), including “moral hero,” “kin figure,” and/or “deity.” Our analysis further suggests how such positioning, as a response to grief and uncertainty, “moved” authors into a position of distance from hegemonic national chronotopes situating people in a symbiotic relationship of mutual care with the Chinese state. Our analysis thus offers insight into the ways in which collective crises have the capacity to (but do not necessarily) motivate a complex discursive and relational process through which interlocutors enactscalar intimacy(Pritzker and Perrino 2020) as they grapple with shifts in their felt experience of nationhood and/or “culture.”

Analysis of the personality characteristics in patients with laryngopharyngeal reflux disease

Objective: To explore the basic psychological and personality characteristics of patients with laryngopharyngeal reflux disease (LPRD). Methods: The Minnesota Multiphasic Personality Inventory (MMPI) was used to investigate the psychological personality characteristics of 187 patients with LPRD (Study Group) and 75 healthy subjects (control group) who were treated in the otolaryngology clinic of Wuhan Central Hospital from January 2018 to December 2019. There were 102 males in the study group, aged from 20 to 71 (45.42±10.67) years and 85 females, aged from 18 to 65 (40.97±11.53) years; There were 41 males in the control group, aged from 18 to 67 (41.08±12.03) years and 34 females, aged from 20 to 65 (42.55±12.78) years. SPSS 24.0 software was used for statistical analysis. Results: The T scores of HS hypochondriac scale, D depression scale, Hy hysteria scale, Ma hypomania scale and MAS explicit anxiety scale in LPRD patients were significantly higher than those in healthy controls (t=6.304, 4.293, 5.750, 2.694, 5.178, all P<0.05). Correlation analysis showed that RSI score was positively correlated with T score of HS hypochondriac scale, Hy hysteria scale, Ma hypomania scale and MAS explicit Anxiety Scale (r=0.621, 0.402, 0.393, 0.581, all P<0.05); RFS score was positively correlated with T score of HS hypochondriac scale, Hy hysteria scale and MAS explicit Anxiety Scale (r=0.315, 0.321, 0.375, P<0.05). Conclusions: Compared with healthy people, LPRD patients have special personality psychological characteristics, which are mainly manifested as excessive attention to themselves, exaggerated illness, depression, sensitivity, somatization of psychological problems, irritability and mania. The severity of both subjective symptoms (RSI) and objective signs (RFS) of LPRD patients are related to their psychological personality characteristics.

Risk of thyroid cancer and benign nodules associated with exposure to parabens among Chinese adults in Wuhan, China.

Parabens are widely used as preservatives, which have been found to affect thyroid function in toxicological studies. However, population studies on whether they are associated with thyroid tumors remain unclear. This study aims to investigate the relationship between environmental paraben exposure and thyroid cancer and benign nodules. We recruited participants from the Department of Thyroid and Breast Surgery at Wuhan Central Hospital, Wuhan, China. The detectable percentages of methyl paraben, ethyl paraben, and propyl paraben in the urinary samples of 425 study subjects were 99.1%, 95.3%, and 92.0%, respectively. All uncorrected and creatinine-corrected parabens were moderately correlated with one another. After adjusting for possible confounders, all three parabens were associated with an increased risk of thyroid cancer. Furthermore, the mixture pollutant analysis of parabens found positive associations with risk of thyroid cancer (OR = 0.24, 95% CI: 0.18, 0.31) and benign nodules (OR = 1.33, 95% CI: 0.86, 1.80). We observed that individual exposure to paraben mixtures may be associated with the risk of thyroid cancer and benign nodules.

Higher Concentration of Adrenocorticotropic Hormone Predicts Post-Stroke Depression.

BackgroundPost-stroke depression (PSD) is the most common neuropsychiatric complication after stroke, seriously affecting the quality of survivors’ life. As one of the important causes of PSD, neuroendocrine mechanism has been widely studied in recent years. The main objective of this study was to investigate the relationship between adrenocorticotropic hormone (ACTH) on admission and PSD at 3 months.MethodsThis is a hospital-based prospective cohort study, which was conducted at three independent hospitals (Tongji Hospital, Wuhan First Hospital and Wuhan Central Hospital) between August 2018 and June 2019. A total of 768 ischemic stroke patients were finally eligible for analysis and categorized into equal tertiles according to the distribution of ACTH and the number of patients. The χ2-test, Mann–Whitney U-test and Kruskal–Wallis test were used to check for statistical significance. And restricted cubic spline (RCS) regression model was used to explore the non-linear relationship between continuous ACTH levels and PSD at 3 months.ResultsThe optimal cut-off points of ACTH were as follows: (T1) 0.32–20.55 pg/mL, (T2) 20.56–39.79 pg/mL, (T3) 39.80–143.40 pg/mL. A total of 305 patients (39.7%) were diagnosed as PSD at 3 months follow-up. Significant differences were found between the PSD and non-PSD groups in ACTH concentration (P = 0.001). After adjustment for all conventional confounders, the odds ratios of PSD were 1.735 (95% CI = 1.176–2.560, P = 0.005) for the highest tertile of ACTH and 1.496 (95% CI = 1.019–2.194, P = 0.040) for the middle tertile of ACTH, as compared with the lowest tertile. In multiple-adjusted RCS regression, continuous ACTH showed saturation effect relation with PSD risk after 31.02 pg/mL (P for nonlinear = 0.0143).ConclusionHigher ACTH level on admission is a significant and independent biomarker to predict the development of PSD at 3 months follow-up. Besides, saturation effect was revealed even if the underlying mechanism is unclear. For stroke patients, doctors should pay attention to the baseline ACTH for screening high-risk PSD in clinical practice.

Serum Dihydropyrimidinase-Like 3 Concentration in Patients with Gastric Cancer and Its Diagnostic Value.

Background:We aimed to investigate the serum concentration of dihydropyrimidinase-like 3 (DPYSL3) in patients with gastric cancer and its clinical significance.Methods:Seventy four patients with gastric cancer from Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, China from October 2018 to April 2019 were selected as the case group. Sixty patients with normal gastric mucosa or mild non-atrophic gastritis were selected as the control group. Serum DPYSL3, CA72-4 and CEA concentrations were measured in both groups.Results:The serum DPYSL3 concentration in the case group was significantly higher than that in the healthy control group (22.04±9.22 vs. 8.36±4.19 μg/L, P<0.001). The serum DPYSL3 concentration in patients with advanced gastric cancer was significantly higher than that in early gastric cancer (27.09±9.12 vs. 13.04±8.22 μg/L, P<0.01); serum DPYSL3 concentration was significantly correlated with tumor size, TNM stage and differentiation (P<0.05). When the cutoff value was 20.98 μg/L, the serum DPYSL3 concentration could differentiate the gastric cancer with ROCAUC 0.882 (95% CI: 0.828–0.937) with sensitivity and specificity of 75% and 94%, respectively. Serum CA72-4 concentration could differentiate the gastric cancer from health controls with ROCAUC 0.812 (95% CI: 0.734–0.834), serum CEA concentration could differentiate gastric cancer with ROCAUC 0.612 (95% CI: 0.534 ∼ 0.634). The serum concentrations of DPYSL3, CA72-4 and CEA in gastric cancer patients were increased compared to health controls.Conclusion:Three serological markers have complementary diagnostic value for gastric cancer. Serum DPYSL3 is a new potential molecular marker for gastric cancer.

Research on psychological stress and mental health of medical staff in COVID-19 prevention and control

BackgroundThe characteristics of COVID-19, such as the long incubation period, the fast transmission speed, the high demand for treatment, and the lack of prior treatment experience, have brought tremendous psychological stress to the medical staff involved in the epidemic prevention and control, seriously affecting the mental health of medical staff. Therefore, this paper conducts a discussion on the psychological stress and mental health of medical staff. Methods(1)Interview 28 medical staff fighting against COVID-19 from Wuhan Central Hospital and Hubei Provincial Hospital of Traditional Chinese medicine. They have worked as doctors in mental health departments, surgery departments and emergency departments, nurses and management staffs; (2)Based on interviews and literature, the questionnaire survey is conducted among 528 medical personnel from all over the country who have participated in the fight against COVID-19 in Wuhan; (3)Use the structural equation modeling to explore the influence mechanism of medical staff's psychological stress and mental health in the prevention and control of COVID-19. Results: The epidemic severity in hospital and the work intensity are the important psychological stressors for the front-line medical staff. Self-risk perception has a mediating effect on the severity of epidemic in hospitals and mental health of medical staff. Social identification has no moderating effect between the self-risk perception and the mental health.

CT-Based Risk Factors for Mortality of Patients With COVID-19 Pneumonia in Wuhan, China: A Retrospective Study.

Purpose: Computed tomography (CT) characteristics associated with critical outcomes of patients with coronavirus disease 2019 (COVID-19) have been reported. However, CT risk factors for mortality have not been directly reported. We aim to determine the CT-based quantitative predictors for COVID-19 mortality. Methods: In this retrospective study, laboratory-confirmed COVID-19 patients at Wuhan Central Hospital between December 9, 2019, and March 19, 2020, were included. A novel prognostic biomarker, V-HU score, depicting the volume (V) of total pneumonia infection and the average Hounsfield unit (HU) of consolidation areas was automatically quantified from CT by an artificial intelligence (AI) system. Cox proportional hazards models were used to investigate risk factors for mortality. Results: The study included 238 patients (women 136/238, 57%; median age, 65 years, IQR 51-74 years), 126 of whom were survivors. The V-HU score was an independent predictor (hazard ratio [HR] 2.78, 95% confidence interval [CI] 1.50-5.17; p = 0.001) after adjusting for several COVID-19 prognostic indicators significant in univariable analysis. The prognostic performance of the model containing clinical and outpatient laboratory factors was improved by integrating the V-HU score (c-index: 0.695 vs. 0.728; p < 0.001). Older patients (age ≥ 65 years; HR 3.56, 95% CI 1.64-7.71; p < 0.001) and younger patients (age < 65 years; HR 4.60, 95% CI 1.92-10.99; p < 0.001) could be further risk-stratified by the V-HU score. Conclusions: A combination of an increased volume of total pneumonia infection and high HU value of consolidation areas showed a strong correlation to COVID-19 mortality, as determined by AI quantified CT.

Radiologic Risk Factors for Mortality of Patients with COVID-19 Pneumonia in Wuhan, China: A Retrospective Study

Background: Computed tomography (CT) characteristics associated with critical outcomes of patients with coronavirus disease 2019 (COVID-19) have been reported. However, CT risk factors for mortality are poorly understood. We aimed to investigate the automatically quantified CT imaging predictors for COVID-19 mortality.Methods: In this retrospective study, laboratory-confirmed COVID-19 patients at Wuhan Central Hospital between December 9, 2019, and March 19, 2020, were included. A novel prognostic biomarker, V-HU score, depicting the volume of total pneumonia infection and the average Hounsfield unit (HU) value of consolidation areas was quantified from CT by an artificial intelligence (AI) system. Cox proportional hazards models were used to investigate risk factors for mortality.Findings: This study included 238 patients (126 survivors and 112 non-survivors). The V-HU marker was an independent predictor (hazard ratio [HR] 2·78, 95% CI 1·50-5·17; p=0·0012) after adjusting for several COVID-19 prognostic indicators significant in univariable analysis. The prognostic performance of the model containing clinical and outpatient laboratory factors was improved by integrating the V-HU marker (c-index: 0·695 versus 0·728; p=65 years; HR 3·56, 95% CI 1·64-7·71; p=0·0006) and younger patients (ageInterpretation: A combination of an increased volume of total pneumonia infection and high HU value of consolidation areas showed a strong correlation to COVID-19 mortality, as determined by AI quantified CT. The novel radiologic marker may be used for early risk assessment to prioritize critical care resources for patients at a high risk of mortality.Funding: None.Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: The study was approved by the Research Ethics Commission of Wuhan Central Hospital, and the requirement for writing informed consent was waived by the Ethics Commission for the emergence of infectious diseases.

Clinical characteristics of 30 COVID-19 patients with epilepsy: A retrospective study in Wuhan

ObjectiveThis study aims to present the clinical characteristics of 30 hospitalized cases with epileptic seizures and coronavirus disease 2019(COVID-19). MethodsThis is a retrospective observational research study. Clinical data were extracted from electronic medical records in 1550 patients with a laboratory-confirmed diagnosis of COVID-19, who were hospitalized in Wuhan Central Hospital, China, from 1 January to 31 April 2020. 30 COVID-19 patients with the diagnosis of epilepsy were enrolled. The clinical characteristics, complications, treatments, and clinical outcomes of 30 cases were collected and analyzed. ResultOf 30 patients with a diagnosis of epilepsy and COVID-19, 13 patients (43.4%) had new-onset epileptic seizures without an epilepsy history(new-onset seizure group, NS group), ten patients(33.3%) had an epilepsy history with a recurrent epileptic seizure (recurrent seizure group, RS group) and seven patients(23.3%) had an epilepsy history but no seizure during the course of COVID-19 (epilepsy history group, EH group). Patients in the RS group had a larger number of other-neurological-disease histories than those in the NS and EH groups (7/10[70%] VS 1/13 [7.7%] VS 1/7[14.3%]); the difference between the RS group and NS group is significant (P < 0.05). Patients in the NE and RS groups suffered more severe/critical COVID-19 infection than patients in the EH group (10/13[76.9%] VS 6/10[60%] VS 1/7[14.3%]); the difference between the NS group and EH group is significant (P < 0.05). 36.7% of patients had one to five neurological complications, and 46.4% of patients had 6–10 neurological complications. The complications in patients with seizures (in the RS and NS groups) seem to be more than those without seizures (in the EH group), but it did not reach statistical significance. The proportion of antiepileptic drugs (AEDs) treatment before admission was higher in the EH group than in the RE group(7/7 [100%] VS 2/10 [20%], P < 0.05). The mortality of 30 patients with epilepsy and COVID-19 was 36.67%. The mortality of the NS group(38.5%) and the RS group(50%) were a little higher than in the EH group(14.3%). None of the convalescent patients had a recurrent seizure, and there were no more deaths in the 3-month follow-up after discharge. ConclusionsCOVID-19 patients with recurrent epileptic seizures had more underlying neurological diseases than patients who had an epilepsy history but without a seizure. Patients with new-onset and recurrent epileptic seizures suffered more severe/critical COVID-19, which may lead to a worse prognosis. If patients with epilepsy history continue using AEDs during COVID-19 pandemics, the risk of recurrent seizure may be reduced, and a good prognosis for patients with epilepsy history could be expected.

COVID-19 и офтальмология: возможно ли инфицирование через конъюнктиву?

At the end of 2019, an outbreak of a new coronavirus infection occurred in the people's Republic of China with an epicenter in the city of Wuhan (Hubei province). On February 11, 2020, the World Health Organization assigned the official name of the infection caused by the new coronavirus – COVID-19 (Coronavirus Disease 2019). As of May 2020, COVID-19 has been confirmed in nearly three and a half million people and has resulted in just over 230.000 deaths. In January 2020, the first case of death of an ophthalmologist from Wuhan Central hospital who was infected from a patient was recorded, which attracted the attention of the medical community around the world, especially in countries at the center of the pandemic. There are scientific papers showing the possibility of infection with the COVID-19 virus through the mucous membrane of the eye, which is relevant for doctors working in a pandemic, especially practicing ophthalmologists and General practitioners.

Year of the Mask; COVID-19 Challenges for Orthopaedic Surgery

As a response to the viral pneumonias and severe illnesses that were emerging in patients, an ophthalmologist November 2019 a novel coronavirus emerged in Wuhan, Hubei, China&#x0D; Dr Li Wenliang, working at Wuhan Central Hospital, voiced his concerns only to be severely admonished by the authorities. The accelerated spread of the Severe Acute Respiratory Syndrome (SARS) in Wuhan, and then globally, as a result of the novel coronavirus was acute and pronounced. China alerted the World Health Organisation to several pneumonia cases at the end of December 2019 and the first death was recorded in early January 2020. The respiratory physician Dr Nanshan Zhong, announced human-to-human spread and a few days later on the 23 January 2020, Wuhan was placed under quarantine. The virus spread outside China and the WHO declared the outbreak a global health emergency on 30 January 2020. Tragically Dr Li Wenliang died on 7 February 2020 as a result of exposure to the virus, leaving a five-year-old son and a pregnant wife.

Effect of smoking on chronic rhinosinusitis complicated with lower respiratory tract disease

Objective: To study the effect of smoking on chronic rhinosinusitis with lower respiratory tract diseases and underlaying mechanism. Method: The data of 54 patients diagnosed as CRS with lower respiratory disease (Group A) and 60 patients with CRS (Group B) from otolaryngology head and neck surgery in Wuhan Central Hospital and Renmin Hospital of Wuhan University from January 2014 to December 2017 were analyzed, retrospectively. According to the history of smoking, all patients were divided into smoking group (Group C) and non-smoking group (Group D). Nasal secretory microbial cultures were performed. Result: Patients with CRS with lower respiratory disease had higher smoking rate than patients with CRS alone(P<0.05). CRS patients with smoking increased the rate of bacterial infection in lower respiratory and increased the incidence of lower respiratory disease in patients with CRS (P<0.05). Conclusion: Smoking is an important risk factor for CRS complicated with lower respiratory disease.

Therapeutic effect of a new hybrid technique which combined laparoscopic method and abdominal repair for parastomal hernia repair

Objective: To investigate the safety and effectiveness of a new hybrid technique which combined laparoscopic method and abdominal repair (Dual Lap) for parastomal herniarepair. Methods: The clinical and follow-up data of 27 cases who accepted Dual Lap procedure performed at Department of Hernia and Abdominal Wall Surgery, Wuhan Central Hospital, Tongji Medical College of Huazhong University from January 2010 to January 2015 were analyzed retrospectively. The data included 22 male patients and 5 female patients with mean age of 54 years. Of the patients, there were 19 cases of the left hernia and 8 cases of the right hernia, without ostomy hernia repair history. There were 4 cases of the occult hernial defects during the operation. There were 8 patients with ilealneobladder, 2 patients with ileostomyafter total colectomy for familial adenomatous polyposis, 3 patients with ileostomy and 14 patients with colostomy for ulcerative colitis. Results: All cases underwent hybrid technique successfully. The mean operation time was (108±16) minutes(ranging from 90 to 150 minutes) and the diameter of the hernial ring was (6.4±1.8)cm (ranging from 3 to 13 cm). There were no intestinal, kidney and ureteral obstructions in operations. Five cases need to use the analgesic adjuvant at 48-hour after operation. The time of postoperative defecations was (9.3±2.4) days (ranging from 7 to 16 days) and there were no intestinal leakage, local hematoma, wound infection and fat liquefaction after operations. All patients were followed up for (16.3±4.2) months (ranging from 12 to 48 months). There was no ileus, obvious seroma, hernia recurrence, chronic pain and mesh infection. Conclusion: The Dual Lap procedureis safe and effective for parastomal hernia repair with less complication.